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Medical Science Monitor Basic Research


Primary Brain Melanoma in a Pediatric Patient: A Case Report

Challenging differential diagnosis, Rare disease

Gretchen A. Otero-Soto, Viviana Vidal-Anaya, Eduardo J. Labat

Puerto Rico Department of Radiology, University of Puerto Rico School of Medicine, San Juan, Puerto Rico

Am J Case Rep 2021; 22:e926749

DOI: 10.12659/AJCR.926749

Available online: 2021-02-01

Published: 2021-03-09


BACKGROUND: Primary malignant melanoma of the brain is a challenging radiological diagnosis and a high index of suspicion is required about patients with the condition. In the pediatric population, only a few cases have been reported in the literature. The purpose of this report was to describe the expected imaging characteristics and the importance of a multidisciplinary approach in the diagnosis of this rare entity.
CASE REPORT: A 17-year-old Hispanic male who presented with new-onset tonic-clonic seizures had no focal neurologic deficits on physical examination. An initial computed tomography scan showed a hyperdense, right frontal, parafalcine mass. Brain magnetic resonance imaging was performed and revealed a T1 hyperintense and T2 hypointense, right-frontal-lobe, extra-axial mass with foci of susceptibility. Resection of the mass revealed a lesion that had a dark, pigmented macroscopic appearance. Histopathologic analysis confirmed that it was a primary intracranial malignant melanoma after no primary site was identified on dermatologic and ophthalmologic evaluations.
CONCLUSIONS: Diagnosing a primary intracranial melanoma with imaging alone is virtually impossible if clinical data and findings from a thorough physical examination are unavailable. Intracranial primary malignant melanoma remains a complex radiological diagnosis that relies on the exclusion of other potentially more common entities and an optimal multidisciplinary approach.

Keywords: Adolescent, Brain